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'Top hat' and 'zig-zag' incisions described as stable and safe for PK
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NEW ORLEANS — Penetrating keratoplasty with femtosecond laser offers rapid visual recovery and a low rate of astigmatism, according to two surgeons.
Francis W. Price Jr., MD, discussed the "top hat" incision and Marjan Farid, MD, discussed the "zig-zag" incision here at the American Academy of Ophthalmology meeting.
Dr. Price pointed out that mastering PK incisions with the IntraLase femtosecond laser (Advanced Medical Optics) is easier than learning the technique for endothelial keratoplasty.
"With the endothelial keratoplasties, there's a tremendous learning curve," Dr. Price said. "With the IntraLase-enabled keratoplasties, at least the way we're doing them now, there is really not a big transition from standard PK. The biggest issue is whether you can get a good cut."
Dr. Price said the "top hat" incision, so named because of its shape, heals quickly with relatively few sutures, while Dr. Farid showed that the "zig-zag" incision was stable and resulted in a low rate of astigmatism.
Dr. Farid described results treating 30 eyes of 27 patients, with a follow up of up to 1 year. At month 3, astigmatism averaged 2.6 D (range: 0.2 D to 7.1 D) and best corrected visual acuity averaged 20/30 or better in 84% of patients.
Over half patients saw 20/25 or better at 3 months, and 100% of those followed up to 6 months had 20/30 or better vision, Dr. Farid said.
"We found the suturing is very easy," Dr. Farid said. "Just go right through and come out about 50% depth and it looks beautiful."